Stephanie R Dietrich, LCSW-S

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

55919 Issued in TX

Practice address

16852 Royal Crest Dr
Houston, TX 77058-2529

Phone

(281) 305-8552

NPI assigned

Oct 23, 2015

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Cultivating Changesa, LLC

  • Group Psychotherapy Psychologist
  • Houston, TX
  • NPI 1629817804
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1445558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578355200000",
    "number": "1407228893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1228 N LOGAN ST",
            "address_2": "STE 100",
            "city": "TEXAS CITY",
            "state": "TX",
            "postal_code": "775905172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16852 ROYAL CREST DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770582529",
            "telephone_number": "281-305-8552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIETRICH",
        "first_name": "STEPHANIE",
        "middle_name": "R",
        "credential": "LCSW-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-23",
        "last_updated": "2020-01-07",
        "certification_date": "2020-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "55919",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "stephaniedietrichlcsw@protonmail.com",
            "affiliation": "N",
            "endpointDescription": "business emailaddress",
            "address_1": "16852 Royal Crest Dr",
            "city": "Houston",
            "state": "TX",
            "country_code": "US",
            "postal_code": "770582529",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jennifer Elise Dierksen, M.D.
• Natalie R Diers, D.P.M.
• Julia Diane Diersing, PA-C
• Jennifer E. Dietrich, M.D.
• John Kaiser Dietrich, LMSW, LCDC
• Julie Dieu
• Leann Dieu
• Remercia Dieubon
• Jose Diez, MD
• Difference Makers Enterprises Inc.

• Clinical Social Worker in Houston, TX
• Providers in Houston, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.